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General NPI Number Information
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NPI Number | 1164771879
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Entity Type | Organization
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Legal Business Name | SONNEE WEEDN, PH.D., PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 3 HAMILTON LNDG SUITE 230
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City | NOVATO
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State | CA
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Zip | 94949-8248
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Country | US
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Telephone | 415-883-7758
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Fax | 415-883-8385
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Provider Business Mailing Address
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Address Line | 3 HAMILTON LNDG SUITE 230
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City | NOVATO
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State | CA
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Zip | 94949-8248
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Country | US
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Telephone | 415-883-7758
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Fax | 415-883-8385
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Authorized Official
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Title or Position | OWNER
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Name | DR. SONNEE WEEDN
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Credential | PH.D.
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Telephone | 415-883-7758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PSY12188
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License Number State | CA
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